Infant Mortality

The ethical issues that come with crowdfunded healthcare

To choose one, though, also means to choose it over all the others.

Who, out of all the people who have shared their tragedy on the Internet, is the most deserving of money?

the most pressing ethical question surrounding medical crowdfunding is not the inequalities it illuminates, or how donors choose who to fund, or how sites choose who to host—it’s why the practice has become necessary in the first place.

Source: Is It Fair to Ask the Internet to Pay Your Hospital Bill? – The Atlantic

 

From comments:

Perhaps the phrase of most interest to me in the whole article was “necessary care.” Who defines it, and who should? And does an extremely expensive procedure with a middling chance of success for a child with an extremely rare genetic disease count? This question may reveal the true utility of crowdfunding campaigns–not that they pay for “necessary care,” but that they can be used to pay for extraordinary care that doesn’t meet any objective cost-benefit analysis. They’re an opportunity to say “help me because you love me/ sympathize/ find my story compelling,” even if the procedure can’t be justified as “necessary” in a way that means society as a whole should cover the tab involuntarily.

— Disqus commenter EBennetDarcy

 

 

In the 1850s, the infant mortality rate in the United States was estimated at 216.8 per 1,000 babies born for whites and 340.0 per 1,000 for African Americans
— Wikipedia “Infant_mortality” from Sullivan, A., Sheffrin, S. (2003) Economics: Principles in Action, Pearson Prentice Hall, ISBN 0-13-063085-3

That rate is from more than 1-in-5 to over a third of children born, dying before they turned 5 years old.

The US infant mortality rate at 6.1 is now called “a national embarrassment” by the Washington Post.
Our infant mortality rate is a national embarrassment – The Washington Post

The US Federal CDC lists the number of live births in the US as just under 4 million.
FastStats – Births and Natality – CDC.gov

With 4 million births and an infant mortality rate of 6.1, that works out to 24,400 children born last year dying within the following 5 years.

Finland has their rate down to 2.3 though, so we could presumably cut that figure to only 9,200. If we could save half of those (so 4,600 infants) for $250,000 each, then saving their lives would cost $1.15 billion dollars. At $1 million each the total cost would be $4.6 billion.

Paying for exceptional care for exceptional cases does cost an exceptionally large amount per case. However, *because* of their rarity, I don’t think this is as bad as it seems like at first blush/consideration (usually comparing such staggering figures to the annual incomes of normal people).

My opinion is that we can afford this, and should, and a national / universal / single-payer health system (through “insurance”, federally managed/administered, or whatever) would accomplish this. It would be a far better use of the funds than [insert government thing you don’t like here; I’ll pick the F-35].

A hundred and fifty years ago, the only option was “too bad, try again”. We can and should do better now, for everyone.

What Anti-Vaxxers Are Doing to Us | The American Conservative

Doctors have warned for some time that the anti-vaxxers are putting us all at risk by eliminating herd immunity from common childhood diseases, and now, with measles, it’s happening.

In case you’re tempted to think this is just a weirdo California thing, it’s not.

I think it is time to consider legal action at the federal level to compel vaccination. I don’t know what the limits on federal law should be, but what we have now is not working. Again, if somebody wanted to take the risk of measles, pertussis, and so forth upon themselves, I would respect their right to be foolish. I have a much more difficult time respecting their right to subject their children to these diseases in the absence of scientific grounds for it, but I could be persuaded that respecting the parents’ right in this matter is important.

What I cannot accept is that these people, acting without any scientific grounds for their belief, are putting everybody else, and everybody else’s children, at medical risk (there is a small but nontrivial chance that you will acquire the disease even if you have been vaccinated).

this is not a matter of being intolerant of an unpopular opinion; this is a matter of preserving public health from a serious communicable disease, one with potentially grave complications. It’s a matter of what we can afford to tolerate for the sake of the common good.

Source: What Anti-Vaxxers Are Doing to Us | The American Conservative

Wonky Thoughts: Ebola Update #1

Extrapolation of the current trend shows that massive numbers of people could become infected in a short period of time. The cumulative number of cases is doubling every month.

The process employed by WHO in West Africa is the same process used successfully to combat previous Ebola outbreaks. The process is straightforward, but labor-intensive. … Clearly, as the number of Ebola cases rises, the ability to contain the epidemic becomes more strained. As the disease grows exponentially, the required staffing also grows exponentially. … The window for successfully containing the epidemic is rapidly closing. At some level of contagion, social order will break down entirely. At that point, treatment of cases will become difficult or impossible; clear data about the status of the epidemic may disappear.

Source: Wonky Thoughts: Ebola Update #1

Alzheimer’s Disease Statistics Show the Illness Will Define Our Times | New Republic

We will all be touched by the disease. How are we going to get through this?

The likelihood of your developing Alzheimer’s more or less doubles every five years past 65. Should you make it to 85, you will have, roughly, a fifty-fifty shot at remaining sane.

In 1900, about 4 percent of the U.S. population was older than 65. Today, 90 percent of all babies born in the developed world will live past that age. Barring a miracle cure, or some kind of Stand-esque superfluenza, dementia will become the public health crisis of our time.

Source: Alzheimer’s Disease Statistics Show the Illness Will Define Our Times | New Republic

NIH director: Budget cuts put U.S. science at risk

Budget pressures now force the National Institutes of Health to reject half of worthwhile research proposals, putting scientific progress at risk and leading bright U.S. minds to consider relocating.

The NIH budget peaked in fiscal year 2010 at $31.2 billion, falling to $30.15 billion for fiscal year 2014.

Due to inflation, the NIH budget has lost 25% of its purchasing power over the last decade, Collins says.

Source: NIH director: Budget cuts put U.S. science at risk